Colds in the First Trimester: Which Medicines to Check First

Why extra care matters early in pregnancy

In the first trimester, the baby's organs are forming. Most colds are not dangerous, but many medicines are best discussed with your OB-GYN, midwife, or pharmacist first. The concern is often less about the cold itself and more about combination products and taking more of an active ingredient than needed.

Medicines to check with your provider before using

• Ibuprofen (Advil, Motrin) and naproxen (Aleve). Many providers prefer acetaminophen early in pregnancy, and NSAIDs are generally avoided after 20 weeks.
• Multi-symptom cold and flu products that combine a fever reducer, a decongestant, and an antihistamine (such as many DayQuil, NyQuil, or Theraflu products)
• Decongestants with pseudoephedrine or phenylephrine, unless a provider recommends one
• Codeine and other opioid cough medicines
• Herbal blends and supplements with unclear ingredients

Options often used instead

For fever and body aches, acetaminophen (Tylenol) is commonly recommended in the US, at the lowest effective dose for the shortest time. For a stuffy nose, saline nasal sprays or rinses, a humidifier, fluids, and rest are often used. Ask your provider before using any medicine, especially if you have a chronic condition or already take other medicines.

Learn more

• NIH: Pregnancy (NICHD)
• CDC: Pregnancy

General information only; it does not replace advice from your doctor or midwife.